Disability Insurance

POLICY INTERPRETATION RULING

SSR 05-02: Titles II and XVI: Determination of Substantial Gainful
Activity if Substantial Work Activity is Discontinued or
Reduced—Unsuccessful Work Attempt

PURPOSE:

To clarify the policy stated in Social Security Ruling
(SSR) 84-25 for determining whether
substantial work activity that is discontinued or reduced below a
specified level may be considered an unsuccessful work attempt (UWA) under
the disability provisions of the law.

CITATIONS (AUTHORITY):

PERTINENT HISTORY:

Under the disability provisions of the law, except within the trial work
period (TWP) provisions and section
1619 of the Social Security
Act, if you are engaging in substantial gainful activity (SGA) you are not
eligible for payment of disability benefits. (See Social Security Ruling
(SSR) 83-33, Program Policy Statement
(PPS)-107, Determining Whether Work Is Substantial Gainful
Activity—Employees, regarding evaluation of work activity of
employees. See SSR 83-34, PPS-108,
Determining Whether Work Is Substantial Gainful
Activity—Self-Employed Persons, regarding evaluation of work
activity of self-employed persons.) The UWA concept was designed to
provide us an equitable means, in making SGA determinations, to disregard
relatively brief work attempts that do not demonstrate sustained SGA. We
will not consider work we determine to be an UWA as substantial gainful
activity when we determine if you are under a disability or when we
determine if your disability has ceased.

The UWA concept is contained in our regulations. If you are an employee,
sections 404.1574(a)(1)
and 416.974(a)(1) of the
regulations state: “We generally consider work that you are forced
to stop or to reduce below the substantial gainful activity level after a
short time because of your impairment to be an unsuccessful work attempt.
Your earnings from an unsuccessful work attempt will not show that you are
able to do substantial gainful activity.” See also
404.1574(c) and
416.974(c). If you are
self-employed, sections
404.1575(a) and
416.975(a) state:
“We will generally consider work that you were forced to stop or
reduce to below substantial gainful activity after 6 months or less
because of your impairment as an unsuccessful work attempt.” See
also 404.1575(d) and
416.975(d).

SSR 84-25 indicated that the UWA concept
is applicable to both your initial disability case and when we determine
whether, because of work activity, your disability continues or ceases.
Both SSR 84-25 and the regulations state
that there must be a significant break in the continuity of your work
before we will consider you to have begun a work attempt that later proved
unsuccessful. However, SSR 84-25 and the
regulations do not address how the UWA significant break concept should be
applied in your initial disability case when your prior work activity
stopped before onset of your impairment or where you had no prior work
activity. This revised Ruling addresses these issues under the section
“Event That Must Precede a UWA” and removes outdated material
from the “PERTINENT HISTORY” section of
SSR 84-25.

Policy Statement: For SGA determination purposes, your substantial
work may, under certain conditions, be disregarded if it is discontinued
or reduced to the non-SGA level after a short time because of your
impairment, or the removal of special conditions related to your
impairment that were essential to your further performance of the work.
The UWA criteria differ depending on whether your work effort was for
“3 months or less” or for “between 3 and 6
months.” If your work attempt was “unsuccessful,” we
will not be precluded from finding that you are under a disability during
the time that you performed that work.

When the UWA is Applicable: The UWA policy explained in this SSR is
to be used in initial disability cases. It is also to be used in
continuing disability cases in determining whether, because of work
activity, your disability continues or ceases. However, the UWA criteria
do not apply in determining whether payments should be made to you for a
particular month during the reentitlement period after disability has been
ceased because you did SGA, or during the initial reinstatement period
after you have been reinstated through the expedited reinstatement
provision.

Event That Must Precede a UWA: There must be a significant break in
the continuity of your work before you can be considered to have begun a
work attempt that later proved unsuccessful. Such an interruption would
occur when, because of your impairment or the removal of special
conditions related to your impairment that are essential to your further
performance of the work, the work was discontinued or reduced (or limited)
to the non-SGA level. Such an interruption could also occur when, before
the onset of your impairment, you discontinued (or limited) your work for
other reasons, such as retirement, or never engaged in work activity. We
will consider your work to be “discontinued” if you (1) were
out of work for at least 30 consecutive days or (2) were forced to change
to another type of work or another employer. (On rare occasions a break
lasting a few days less than 30 may satisfy this requirement if your
subsequent work episode was brief and clearly not successful because of
your impairment.)

Event That Must Follow a UWA: After the first significant break in
continuity of your work, your next period of work is regarded as
continuous until another significant break occurs; that is, until your
impairment, or the removal of special conditions related to your
impairment that are essential to your further performance of work, causes
your work to be “discontinued”, as defined above, or to be
reduced to the non-SGA level. Each continuous period, separated by
significant breaks as described, may be a UWA so long as criteria as to
duration and conditions of work are met, as set out below.

Duration and Conditions of Work

Work Effort of 3 Months or Less: Your work must have ended or have been
reduced to the non-SGA level within 3 months due to your impairment or to
the removal of special conditions related to your impairment that are
essential to your further performance of work. (Examples of “special
conditions” are given below.)

Work Effort of Between 3 and 6 Months: If your work lasted more than 3
months, it must have ended or have been reduced to the non-SGA level
within 6 months due to your impairment or to the removal of special
conditions (see below) related to your impairment that are essential to
your further performance of work and:

You must have had frequent absences from your work due to your impairment;
or

Your work must have been unsatisfactory due to your impairment; or

Your work must have been done during a period of temporary remission of
your impairment; or

Your work must have been done under special conditions.

(To illustrate how UWA time periods are figured, work from November 5,
2003, through a date no later than February 4, 2004, is for “3
months or less.” Work from November 5, 2003, through at least
February 5, 2004, but through a date no later than May 4, 2004, is for
“between 3 and 6 months.”)

Work Effort of Over 6 Months: Your SGA-level work lasting more than 6
months cannot be an UWA regardless of why it ended or was reduced to the
non-SGA level.

Performance of Work Under Special Conditions: One situation under which
your SGA-level work may have ended, or may have been reduced to the
non-SGA level, as set out above, is “the removal of special
conditions related to your impairment that are essential to your further
performance of work.” That is, you may have worked under conditions
especially arranged to accommodate your impairment or you may have worked
through an unusual job opportunity, such as in a sheltered workshop.
Special or unusual conditions may be evidenced in many ways. For example,
you:

May have required and received special assistance from other employees in
performing the job; or

Were allowed to work irregular hours or take frequent rest periods; or

Were provided special equipment or were assigned work especially suited to
your impairment; or

Were able to work only within a framework of especially arranged
circumstances, such as where other persons helped you prepare for or get
to and from work; or

Were permitted to perform at a lower standard of productivity or
efficiency than other employees; or

Were granted the opportunity to work, despite your medical condition,
because of family relationship, past association with the firm, or other
altruistic reason.

Development of Reasons for Work Discontinuance or Reduction: When we
consider why your work effort ended or was reduced to the non-SGA level,
we do not rely solely on information from you. Therefore, if we do not
already have impartial supporting evidence, we will seek confirmation from
your employer. If the information from your employer is inconclusive or is
not available, we may seek confirmation of the reason you discontinued or
reduced your work with a physician or other medical source. After being
apprised of the circumstances, the physician or other medical source could
state whether, in his or her opinion or according to the records, your
work discontinuance or reduction was due to your impairment.

Answers to questions such as the following will help to verify the nature
and duration of your work and the reason it ended or was reduced:

When and why was the SGA-level work interrupted, reduced or stopped?

If special working conditions (as described in the preceding section) were
removed, what were those conditions or concessions? When, how and why were
they changed?

Were there frequent absences from work? Were days and hours of work
irregular and, if so, why?

Was job performance unsatisfactory because of the impairment?

Did the employer reduce your duties, responsibilities or earnings because
of your impairment?

When your work effort ended, was the continuity of employment broken? Did
the employer grant sick leave or hold the position open for your
return?

If you were self-employed, what has happened to the business since the
discontinuance or reduction of your work? If the business continued in
operation, who managed and worked in it and what income will you receive
from it?

EFFECTIVE DATE:

The policy explained herein is effective as of the date of publication of
this SSR.

Important Information:

Other Government Websites:

Follow:

External Link Disclaimer

You are exiting the Social Security Administration's website.

Select OK to proceed.

Disclaimer

The Social Security Administration (SSA) website contains links to websites not affiliated with the United States government. These may include State and Local governmental agencies, international agencies, and private entities.

SSA cannot attest to the accuracy of information provided by such websites. If we provide a link to such a website, this does not constitute an endorsement by SSA or any of its employees of the information or products presented on the non-SSA website.

Also, such websites are not within our control and may not follow the same privacy, security or accessibility policies. Once you visit such a website, you are subject to the policies of that site.